Bacterial Pleural Effusion and Antimicrobial Resistance at the Children�??s Medical Center, Iran between 2012 and 2019

Background: Bacterial pleuritis is a rare disease with high mortality rate in untreated patients, but effective antimicrobial treatment reduces its frequency. Drug resistance is rising to seriously high levels and is an emerging threat to public health systems. We aimed at evaluating antimicrobial resistance in pediatrics with bacterial pleural effusion.

Methods: This retrospective study was carried out at the Children’s medical center between 2012 and 2019. Samples obtained with thoracocentesis from 487 hospitalized pediatric patients with pleural effusion with different etiologies. In addition to routine culture and disk diffusion method, to achieve quantification and standardization, in some cases E-test MICs was performed. BACTECT culture system was used for some critical patients. All microbiology data were used in this study was reported to the WHONET as software for the microbiology laboratory database.

Results: Positive bacterial cultures were found in 22 (4.5%) cases. The most common isolated microorganisms were Streptococcus pneumonia 40/90% (9/22), Acinetobacter baumani 18/18% (4/22) and Staphylococcus aureus 13.63% (3/22). Other less prevalent organisms include Pseudomonas aeruginosa, Staphylococcus epidermis, Klebsiella pneumonia, and Serratia marcescens. 88% of S. pneumonia isolates were resistance to Erythromycin. A. baumannii expressed 100% resistance to Cefotaxime. S. aureus had the highest resistance rates to Penicillin (100%). The rate of MRSA and MRSE were 33/3% and 50% respectively.

Conclusion: Our findings revealed the antibacterial resistance rate is expanding. Surveillance on antimicrobial susceptibility patterns and hospital antibiotic formulary are essential to find bacterial resistance and establishing guidelines for monitoring antibiotic therapy.

Author(s):

Mohammad Taghi Haghi-Ashtiani, Maryam Sotoudeh Anvari, Maryam Rahmani, Reyhane Rbiei, Seyedeh Zohreh Hashemi, Hamid Eshaghi

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